Overview

The Compliance Officer position plans, designs, implements, maintains, and manages a comprehensive compliance and privacy program across Foundation Health Partners (FHP), including Tanana Valley Clinic, Fairbanks Memorial Hospital, and Denali Center. This role directs the compliance activities across the organization, including compliance and privacy education and training, compliance and privacy policies and procedures, and compliance-related audits and investigations. This role is a leadership position that serves as a role model for ethical management behavior and promotes an awareness and understanding of high ethical standards consistent with the organization’s values and federal and state legal requirements. The Compliance Officer effectively manages the Compliance and Privacy program by establishing collaborative relationships across functions and by enhancing the culture of compliance organization-wide.

Responsibilities

1. Directs, implements, and enforces organization-wide compliance program to facilitate adherence to federal, state and local laws and regulations, including fraud and abuse laws, HIPAA, and Medicare and Medicaid requirements.

2. Directs FHP-wide compliance auditing and monitoring function for identified risk areas, including HIPAA. Develops annual compliance auditing and monitoring plan to verify compliance with legal and regulatory requirements applicable to health care organizations. This includes directing investigations and monitoring compliance activities in accordance with compliance program standards, policies and procedures, including those related to HIPAA breaches. Designs audit controls for internal processes ensuring appropriate measures are in place for accurate, complete and compliant programs throughout the system. Proactively identifies areas where there may be substantial risk of unlawful or unethical conduct and responds accordingly in a timely fashion, including ensuring that FHP meets all disclosure and repayment obligations. The Compliance Officer also is responsible for conducting an annual compliance risk assessment, including HIPAA Privacy and Security, to identify the likelihood and severity of various risks, and for prioritizing those risks in the Annual Compliance Work Plan. This role also leads or participates in reimbursement compliance activities.

3. Develops and implements system-wide compliance training programs, including HIPAA. This includes designing and preparing presentation materials intended specifically to communicate and promote the understanding of compliance issues, laws, and consequences for noncompliance, as well as delivering the training programs throughout the system. The Compliance Officer is also responsible for department-level compliance and privacy training, as needed or requested, and for verifying/ensuring that required compliance training has occurred, especially when required in conjunction with a corrective action plan.

4. Develops and communicates all compliance and privacy policies and procedures, and is responsible for reviewing and providing input into HIPAA Security policies. This role participates in the Policy Oversight Committee. Oversees the thorough documentation of all compliance activities to ensure compliance with federally mandated reporting requirements. The Compliance Officer ensures reporting requirements are maintained in a timely and accurate fashion, including the resolution of each case/issue identified and closed. Reports on matters of business ethics, legal compliance and operations of the program to the Operational Compliance Committee, the Quality and Compliance Committee of the Board, and to various FHP leadership meetings, as appropriate. Also develops Compliance and Privacy communication and awareness materials, such as newsletter articles, intranet site content, and posters.

5. Reviews highly complex and sensitive questions, concerns and complaints relative to compliance matters, and provides leadership and support to all entities and lines of business, as appropriate. Ensures that reasonable steps are taken to respond timely and appropriately to ethical or legal compliance violations, to prevent further violations provides advice regarding potential discipline of violators appropriately and consistently. Oversees investigations of ethical and legal violations to ensure consistency in the enforcement of the program.

6. Provides leadership and oversight for the Information Systems Security Officer and other Compliance staff, as applicable. Provides coaching and ongoing support for Compliance Liaisons and Privacy Officers to increase Compliance understanding and culture across FHP. Works with various leaders and administrators in all lines of business and facilities to develop compliance goals and objectives. Conducts onsite reviews on an ongoing basis and communicates industry and organization trends and areas for improvement for the various entities and departments. This position also acts as a resource to physician practice operations and medical staff as needed or requested to address and resolve compliance related issues. Chairs Operational Compliance Committee meetings. Participates in the Executive Quality and Safety Committee and other cross-functional and leadership meetings as appropriate. Maintains strong working relationship and regular communication with related functional areas such as Quality, Risk Management, Patient Experience, and Human Resources to facilitate cross-functional collaboration and awareness.

7. Maintains a current awareness of compliance-related laws and regulations, keeping abreast of current changes that may affect health care systems through personal initiative, seminars, training programs and peer contact. Actively shares compliance and privacy-related news and guidance to FHP leaders and others who may be impacted.

8. Provides coaching and mentoring to staff with responsibilities for Compliance, Privacy, and HIPAA Security. Provides input and participates in recruiting, new hire actions, interviewing and selection of new staff, training and personnel evaluations as it relates to compliance.

Qualifications

MINIMUM QUALIFICATIONSBachelor’s degree required. Must possess a strong knowledge of healthcare compliance, including knowledge of laws and regulations pertaining to health care, regulatory compliance, physician billing and information systems, HIPAA Privacy and Security, Medicare/Medicaid and financial reimbursement systems. Must possess strong planning and problem solving skills. Must have experience and strong skills in researching laws and regulations in the health care field, including Medicare and Medicaid. Must possess strong oral and written communication skills to effectively interact with the FHP Board, Administration and other leaders, physicians, and federal and state governing bodies. Must also possess highly effective interpersonal skills to build effective and collaborative relationships with leadership, employees, and physicians across FHP.

PREFERRED QUALIFICATIONSMaster’s Degree in a field related to business or health care preferred; Compliance-related certification

Internal Number: Job ID 2017-2695

About Fairbanks Memorial Hospital

About Fairbanks Memorial Hospital
Fairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior. We have a strong patient to nurse ratio and a culture of Shared Leadership. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play.